Medical Aid Plan - Top 10 Tips for Choosing a Medical Scheme

Ten top tips for choosing the right medical aid in South Africa 

The medical aid landscape can be tricky to navigate so it’s best to compare all the available options and schemes to find a medical aid that works for your budget and your family’s health. Bonitas Medical Fund supplies these top 10 tips to guide you through choosing the best plan.


1.    Top 10 Tips - Analyse your healthcare needs

No two people or families are alike, medical needs differ so do a quick personal healthcare needs’ analysis to determine what cover you need.  If you have dependants, factor in their healthcare needs too. Factors to consider include:

·          How often you visit your family visit a doctor or specialist 

·          Over-the-counter medication or chronic medication required 

·          Chronic conditions like high blood pressure or diabetes 

·          Specific conditions like cancer, HIV or renal failure 

·          Dentristy 

·          Optometry 

This will help you decide on whether you need a comprehensive medical aid or a hospital plan. 

2.    Top 10 Tips - Read the small print  

Benefits vary from plan to plan, so establish what is and isn’t covered and look at whether the option offers additional risk benefits which can save on day-to-date expenses. Such as free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to mammograms, pap smears and prostate screening. In some cases this extends to maternity programmes, dental check-ups, flu vaccinations and more.  

Top 10 Tips for Picking a Medical Scheme in South Africa


3.    Top 10 Tips - Managed Care options 

Managed Care programmes help members manage severe chronic conditions such as cancer, diabetes and HIV/AIDS.

4.    Top 10 Tips - What about savings?  

Medical savings are a fixed amount a medical scheme gives you at the beginning of the year.  There are ways to maximise your savings but first you need to know what you annual allocation is.

5.    Top 10 Tips - The day-to-day detail 

Look at what the scheme suggests as a way to make your benefits last, bearing in mind the following:

  • Some plans require you to use a specific GP, hospital network and have a list of Designated Service Providers (DSPs). These keep costs down because the scheme will have negotiated special rates with these services providers. Check the network in your area before making a final decision.  
  • Must you be referred to a specialist by your GP?  
  • Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits?   

6.    Top 10 Tips - Virtual Care and technology 

Technology and virtual care is being embraced by medical schemes and members. Check what is offered on the plan you’re considering and whether it you want access to your benefits 24/7. 


7.    Top 10 Tips - Age impacts your decision 


·          As parents of young children, ensure the option you select provides sufficient child illness benefits 

·          If slightly older, select a plan that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation 


8.    Top 10 Tips - Ensure the affordability  


Consider all the costs involved before you make your final decision, such as:

·          Monthly contributions: The rule of thumb is that contributions should not exceed 10% of your monthly income. 

·           A medical aid co-payment is a fee that the member is liable for when making use of certain medical services.  These co-payments usually apply to specialist or elective medical procedures and will differ from one medical aid scheme to another.  


9.    Top 10 Tips - Waiting period and exclusions

The Medical Schemes Act and the specific scheme’s rules determine this.  Bonitas recommends that you enquire with the relevant scheme about their exclusion list and waiting periods.  


10. Top 10 Tips - Brokers

Using a broker doesn’t cost you anything. An independent broker will help you work your way through the different options and help choose the medical aid plan best suited to your and your family’s needs.

For more information on the product offerings from Bonitas go here for more top 10 tips   




Medical Aid QuoteNOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.